She has mid stage Alzheimer's disease. She has two hernias that need to be repaired. The surgeon will do the surgery with sedation and local anesthesia. We have been told that this could be very hard on her. We are not sure exactly what to expect.

10 Answers

Every patient can be a little bit different. Post surgically, my aunt's doctor planned to keep her in the hospital for 3 days. This WAS 20 years ago, I'm not sure what they allow these days, with the push to get them out of the hospital, but my mom was admitted just two years ago for non-surgical reasons and the doctor was able to justify a 5 day stay because of her dementia and that she needed 24 hour medical supervision.

Meanwhile, as for my aunt, except for going to the cafeteria and the bathroom, I stayed with her, even sleeping in a hospital recliner by her bedside at night.

Even with my attention and the nurses and the CNA's, my aunt managed to pull her IV out twice and her Foley catheter 4 times. She would exclaim that she didn't need this or that, become angry if someone didn't follow her orders and eventually do it herself in a sneaky way when she thought no one was paying attention to her.

My aunt was a touchy-feely fidgeter and couldn't be dissuaded or convinced that she needed this help. She just wanted to "go home" although, at the time of surgery, she had already been living in memory care for a year -- and believe me, that's NOT the home she wanted to go back to.

SOOOO, she would rage AND fidgit, picking at herself where she felt the staples pulling on her skin during the healing process. Ripping the bandages off first of course.

The doctor ordered a Posey belt to keep her from getting up anytime she wanted to -- on top of everything else, she was a fall risk -- but he was reluctant to order wrist restraints because he thought that might make her rage more. He was probably right but the nurses weren't happy.

Eventually, the only answer ended up being sedation, which he DID order, much to the nurses delight. And because she had to be scheduled for a "procedure" to deeply sedate her so they could locally anesthetize the area and re-staple what she had removed, she ended up being in the hospital a total of 10 days.

Let me tell you, it was a trial for everyone, and I'm not excluding my aunt. It was very hard on her mentally and physically. It's just that much harder when they don't understand and can't really be reasoned with.

With local anesthesia there's less chance of post-op psychosis. Recovering at home mom would wake up not knowing why she was in pain & need to be comforted. Some times she even thought she was dying. It was a few months before this subsided.

CarolLynn, these days there are no limitations after hernia surgery so unless the patient picks at the wound she should be OK. My surgeon told me there is no evidence that taking it easy had any better effect than going about your usual activities. I was 66 thought so that probably made a difference. Drove hubby 150 miles home after a colonoscopy on day 3. (That knocked the stuffing out of me but my guts did not end up on the car floor)

Hernia repair under local anaesthesia and light sedation is often done for the elderly [ I used to be an operating room nurse] and they normally handle it well, just complain they missed out on their cup of tea. Post operatively the problem with memory loss is they don't remember being in pain, so after lying still for 5mins will then get up and dance around the room as such, then it hits them and they don't know why. My mother had major abdominal surgery and the staff did not handle her dementia and delirium and at the time brain damage, [ The PCP had given her morphine knowing she was allergic to it so then needed resuscitation with the full CPR in the ambulance etc.] See that you can have relatives doing a rotation to sit with her, as the strange place and the strange pain may trigger off added confusion. Otherwise Id say within the 2 -week period she will be fine. I hope they use dissolving sutures, and other little aids, to reduce problems. And as others have mentioned, beware of over use of analgesia and sedation, that is the biggest hurdle

Veronica has given a wonderful description of the process. I would add that one of the difficulties you may have following surgery is that your mom may not realize or egg knowledge that she's even HAD surgery and, without constant attention, could disrupt the proper healing of her incision.

side effects from surgery can alter the mental status. she may not be able to understand what is happening to her or forget. Speak with her primary doc to make sure she will be on the appropriate pain medication afterwards. You can also contact your local chapter of the Alzheimer's association, they will have information that you can find useful. good luck. Hope all goes well.

Anytime an older person has surgery it effects memory. Add DAL to that and its worse. My Mom was given Tramadol and she went loopy. I was told that the elderly should not be prescribed this med. It causes hallucinations.

Hernia surgery is often done with "local" that is spinal anesthesia with vaying degrees of sedation often with enough to make the patient unconscious. This differs from general anesthesia in that there is no need to intubate the patient and make them dependent on a machine to breath. Although it may interfere with a patient's cognative state it is less threatening than the kind of general anesthesia need for a fractures although this method can also be use for that repair too.Hernia's can become very painful if not repaired and a section of gut can become trapped in the hernia and necesitate emergency surgery which will be far worse than doing it before that stage is reached.As far as what to expect. The usual preparations for surgery, will be done as an outpatient proceedure. Your mother will have some pain following the operation and sutures in the incisions which are usually done within the line of the pubic hair. The pain with be well controled with oral medication. She may spend a couple of hours in recovery but once her B/P is stable, she is able to drink and pass urine she will be released. She can travel home safely by car and will be very sleepy at least for the rest of the day and may wish to go to bed but with two hernias may be more comfortable in a recliner. It may advance her dementia but doing nothing could be just as dangerous. Hope this helps allay some of your fears. had mine done in my mid 60s and back to work in a month.

FYI, hernia repair is a very painful surgery to recover from. My Mom had surgery to remove cancerous part of her colon, twice. Also back surgery, with no problems that could not be handled by pain medicine. When she had hernia repair surgery, she cried in pain, WITH pain medicine for 2 days. Maybe you can plan for epidural or spinal block to the abdominal area for a few days after surgery to lessen the pain. Make sure you have a plan in place before surgery.

Surgery accelerated my Dad's decline. He broke his hip and his health score was very high. He had full anesthesia and for days and weeks after we noticed a huge decline in his cognitive abilities. I assume that is why they are doing sedation and local. However, any new medication introduced could be a risk. I'm not a doctor, but know that my mom with vascular dementia was bed-ridden for 4 weeks, unable to talk or control her movements from a one day dosage of Tramadol, which is a pain medication. Does she have a neurologist that you could ask?

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